Alcohol Use Disorder (AUD) and Opioid Use Disorder (OUD) are both substance use disorders that affect the brain and behavior in similar ways. However, they also differ in their development, the risks they pose, and how they are treated.
Similarities
- Both are long-term brain conditions that affect mood and self-control
- Both can cause physical and emotional dependence
- It’s common for someone with one disorder also to have the other
- Both can harm health, relationships, work, and overall well-being
- Both are treated with counseling, support, and sometimes medications
Differences
- Substance: AUD involves alcohol, a legal substance; OUD involves opioids, including prescription painkillers, heroin, or fentanyl
- Withdrawal: Alcohol withdrawal can be life-threatening; opioid withdrawal is rarely fatal but very distressing
- Medication use: AUD may be treated with or without medication (naltrexone, acamprosate, disulfiram); OUD almost always requires medication-assisted treatment (methadone, buprenorphine, naltrexone)
- Treatment settings: AUD is often managed in counseling and support programs; OUD may need specialized clinics
- Prevalence and risk: AUD is more common overall and often leads to long-term health damage (e.g., liver disease); OUD has been rising rapidly and carries a higher immediate risk of fatal overdose, especially when mixed with alcohol or other depressants
Sources: SAMHSA; McHugh et al., 2021
